Reinventing VA health care: Systematizing quality improvement and quality innovation

Kenneth W. Kizer, John G. Demakis, John R. Feussner

Research output: Contribution to journalArticlepeer-review

181 Scopus citations


The Veterans Health Administration (VHA) in the US Department of Veterans Affairs (VA) manages the largest fully integrated health care system in the United States. In 1995, the VHA initiated a reinvention effort that included the most radical redesign of VA health care to occur since the veterans health care system was formally established in 1946. The 2 paramount goals of this reinvention effort were to ensure the predictable and consistent provision of high-quality care everywhere in the system and to optimize the value of VA health care. Although still a work in progress, dramatic results have been achieved toward these ends during the past 5 years. This article provides an overview of the veterans health care system, and it highlights selected aspects of the system's reengineering. It also describes various steps that have been taken to better manage performance and to systematize quality improvement and quality innovation. This information provides a global context that should facilitate understanding of the genesis and purposes of the Quality Enhancement Research Initiative that is described in other articles in this issue of Medical Care.

Original languageEnglish (US)
JournalMedical Care
Issue number6 SUPPL. 1
StatePublished - 2000
Externally publishedYes


  • Health care
  • Performance
  • Quality improvement
  • Quality management
  • Veterans
  • Veterans health administration

ASJC Scopus subject areas

  • Nursing(all)
  • Public Health, Environmental and Occupational Health
  • Health(social science)
  • Health Professions(all)


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